Transitioning Students With Autism into the Adult World In a recent live chat, Lisa Audet talked about helping young adults with autism transition out of high school and into vocational or post-secondary settings. Overheard
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Overheard  |   November 01, 2017
Transitioning Students With Autism into the Adult World
Author Notes
  • Lisa Audet, PhD, CCC-SLP, is assistant professor of speech pathology and audiology in the School of Health Sciences at Kent State University. She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education; SIG 10, Issues in Higher Education; SIG 12, Augmentative and Alternative Communication; SIG 14, Cultural and Linguistic Diversity; and SIG 17, Global Issues in Communication Sciences and Related Disorders. laudet@kent.edu
    Lisa Audet, PhD, CCC-SLP, is assistant professor of speech pathology and audiology in the School of Health Sciences at Kent State University. She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education; SIG 10, Issues in Higher Education; SIG 12, Augmentative and Alternative Communication; SIG 14, Cultural and Linguistic Diversity; and SIG 17, Global Issues in Communication Sciences and Related Disorders. laudet@kent.edu×
Article Information
Special Populations / Genetic & Congenital Disorders / Autism Spectrum / School-Based Settings / Overheard
Overheard   |   November 01, 2017
Transitioning Students With Autism into the Adult World
The ASHA Leader, November 2017, Vol. 22, online only. doi:10.1044/leader.OV.22112017.np
The ASHA Leader, November 2017, Vol. 22, online only. doi:10.1044/leader.OV.22112017.np
Participant: To start, if a participant was to remember or put into practice only one idea from your [online conference] session, what would that one key takeaway be?
Lisa Audet: I think the most important message is one of “inclusion.” That is, when working with individuals who are high-functioning, we need to think of abilities and how they might contribute. I have learned that many of our degree-seeking students are so done with being considered disabled when they come to college that they reject assistance.
Participant: In regard to use of social media, what are your thoughts on the use of emojis? Can these be helpful for individuals with ASD both in terms of giving him/her visual prompts to help with clarifying texts, Facebook posts, etc., in his/her own mind, but especially for communicating with friends and/or family members who have ASD?
Audet: Yes, I think high-functioning individuals do use and comprehend emojis, and they can be helpful. One of the items to be thinking about is if your client tends to be a black-and-white thinker, then using emojis might help him/her think about the gray.

When working with individuals who are high-functioning, we need to think of abilities and how they might contribute. Too often an adult sees the problem (broken pencil) and jumps in to solve the problem (magically a new pencil appears for the kid) so the child is never engaged in self-advocacy.

Participant: Do you have any suggestions regarding activities or ways to assist adolescents in “turning the lens around” in an effort to foster their ability to observe and determine how well others are “earning social currency,” or, in essence, their trust and respect?
Audet: I use real, in-the-moment activities. For example, one client tends to view his parents’ help as attempts to torture him (like being on a diet). I’ve used the token from an Othello game, which are black-and-white tokens. We flip this over when determining another way to view the situation, and this has been helpful.
Participant: At what age do you suggest starting to directly target some of the needed work skills?
Audet: I would say at the time of diagnosis. With little kids who are high-functioning, the work and words we use with them may be different. However, we need to build a foundation. For example, if we are working on empathy or theory of mind, and a peer is crying, we can draw the child with ASD’s attention to the crying child and say something like, “He is sad.” We can describe how we know he is sad and problem-solve about what to do to help. We can engage the child via scaffolding in figuring out how to act on the help—like bring a tissue to the peer. I think that when we do this kind of theory-of-mind/empathy work, we are engaging the child and we are assisting the child in forming relationships.
Another example would be a little child with ASD who needs to learn to advocate for him/herself (I am talking about verbal kids today who are higher-functioning). For example, his pencil breaks. We need to engage that child in figuring out who to ask for help and how to solve the problem for himself. We can acknowledge the problem then ask him, “What should we do now?” Then we can coach and guide him to get the help. Too often an adult sees the problem (broken pencil) and jumps in to solve the problem (magically a new pencil appears for the kid) so the child is never engaged in self-advocacy that is commensurate with his age and we never give him/her a chance to build or show any ability.
Participant: To whom do you recommend our clients disclose their disabilities in a work environment? Many of my clients are reluctant to disclose at all and some disclose indiscriminately to anyone, including customers. Both extremes are problematic.
Audet: I agree this is a tricky subject. We have discussed this in our Autism Task Force at Kent State. There are so many views on the subject, so I’m going to say it depends. Sometimes our clients are looking for jobs with a job coach, so the disclosure is part of the process. Other times, our clients are seeking/obtaining jobs on their own and have no reason to disclose their disability. They, like anyone else, just need to be sure they can do the job as described. I advise my clients to answer questions like, “Will you need any support to get the job done?” by stating what they might need, such as a specific lunch time, a specific length of time for a break or low lighting. They still don’t have to disclose the disability, but answer the question asked.
Once hired, they can disclose if it seems relevant, and they certainly can work with HR around any discriminatory actions. I find helping them learn how to work with HR to be effective when discrimination occurs, and it is an important and often tricky aspect to work on as well. This is when I begin to see some of the ASD traits that might be difficult for the person to manage emerge. When I think about jobs and discrimination, I think what would I say if the person had diabetes, for example? Would I tell someone with diabetes (who may have mood issues related to blood sugar levels) that they should disclose when interviewing? My answer would be no, as long as he/she can do the job. Once on the job, it would be important to work with HR to disclose, so they are protected should discrimination/harassment occur.
Participant: Can you suggest any resources that may help less high-functioning people with autism understand social currency in the workplace and in social settings? And can you also define social currency?
Audet: Social currency is a strategy for helping those with ASD learn why they need to think about another person’s perspective or do something to please another. As they do these things, they earn social currency, and when you have social currency with a person, they tend to cut you some slack when you mess up. I also talk to the kids about the fact that others are earning social currency from them, too. It’s a two-way street. This helps them figure out who can and can’t be trusted. The person who tells them to do things that leads to trouble is not earning—but losing—social currency from the person with ASD. This helps the person with ASD learn that he/she shouldn’t listen to that person anymore. So, the social currency can create equity within relationships for those with ASD (and anyone really).
Now the other question is about using social currency with less able individuals. My take on this would be that a more concrete approach would be helpful. I am thinking I would use a social story about the topic. I would use actual tokens but not as rewards. The tokens would represent the relationship. The relationship is the important piece. And, actually, as I am writing, I am thinking I would create a chain from the tokens. Maybe we could create a people chain, a way that builds connection between the person with ASD and others. These links would be useful in helping the person see that what we do builds a connection or breaks it down.
Participant: Do you have any recommendations of readily available, parent-friendly resources that explain the diversity framework to support the parents’ understanding of this strength-based approach?
Audet: I think that Barry Prizant’s book “Uniquely Human” is an excellent resource. A number of my college students with ASD have read it and shared it with their parents and teachers. The students are excited about the book, so that would be my go-to!
Participant: Because of their social and emotional issues, many with ASD do not finish college. How can we facilitate this transition when college doesn’t work out?
Audet: I think this is a multifaceted issue, and first we need to look at options other than four-year degrees. I think pacing is important for many students. They may start at a two-year or training program, gain some work experience throughout, and then go back and finish their degree. Second, I think career-services training needs to be incorporated into the curriculum from day one. Third, I think it is very important that students with ASD have internships while they are in college. We aren’t consistently doing the pacing, career services and active internship components now. I think the numbers will get better in time. But for those individuals who didn’t finish and are back at home, I would recommend working with a state agency for employment.

I think it is very important that students with ASD have internships while they are in college.

Participant: You mentioned that you find students often rejecting services once they reach college or post-secondary—how do you get them to show up? I find we often have the services and resources available to our students in the university setting, but the students are not following through.
Audet: I have created the PALS (Partners in Achieving and Learning Success) program. This is a program where I pair a student with ASD with a neurotypical student. The matching is one of equity. Both students can earn “experiential learning credit” for participating. While not everyone opts for the credit, having it available communicates equity. I find that the kids who sign up, and right now I have more with ASD interested in the program than neurotypicals, become open to using resources on campus. They see that we really mean it. We want them to succeed and to build on their strengths. I also encouraged a group of those with ASD to create a student organization of people with ASD, which they did. They have had some bumpy times but it also communicates that “you are not alone; you belong here.” These messages over time and lots of equity-based outreach have helped not all students, but more than before.
Participant: Can you please explain more about the “I say, You Say” social communication strategy?
Audet: Yes, the purpose is to teach that conversations contain many pragmatic functions so that students can keep a conversation going. Depending on the child, I will start with just “I say” cards. We will designate a topic, object or picture and make statements about this. For some, this is very difficult, learning how to comment. But, over time, I add the “I ask” cards and practice making statements and asking questions. The “I add” cards are for elaborations, which have to be topically related. The “I acknowledge” card is basically how we pass our turn to the other: words like “Oh, yeah, right.” And the “I feel” card is about relating emotion.
Participant: How often does the SLP typically see a client? And, how long do adolescents and adults with ASD stay in intervention? I know that it would depend on the individual, but is there a typical ending point?
Audet: I assume you are talking about college-aged individuals. The way I work is that we address specific issues, and the client is discharged. Often clients are discharged, and when they face a challenge, they return to intervention. For example, I have a few who have entered new stages in their lives with interviewing or getting a new job. They have returned to intervention to work on things, and I imagine will be discharged within two to three months, if that.
Participant: I work with a high-functioning girl who is going to college this fall. She is terrified. Any ideas how to help her reduce anxiety and just give it a try?
Audet: There are some excellent books written for students entering college. Some are specific to individuals with ASD. I would recommend using a book like this to ground her. I would also recommend creating a “My College Success” binder. In the binder I would create sections based on aspects of college living. I would also create problem-solving trees and a page with important contact information once she is on campus: tech support, residence services, etc. I think you can guide but not push. It is really important that she can manage her emotional state, so you have to keep that in mind.
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November 2017
Volume 22, Issue 11